PREDICT v3.0 outperforms v2.2 in young (25-40 years) breast cancer patients according to real-world data from a large Swedish population-based registry.
[BACKGROUND] PREDICT is a widely used prognostic tool supporting treatment decisions in breast cancer care.
- 95% CI 4.71–5.13
APA
Lundgren C, Frediksson I, et al. (2026). PREDICT v3.0 outperforms v2.2 in young (25-40 years) breast cancer patients according to real-world data from a large Swedish population-based registry.. Breast cancer research : BCR, 28(1). https://doi.org/10.1186/s13058-026-02271-2
MLA
Lundgren C, et al.. "PREDICT v3.0 outperforms v2.2 in young (25-40 years) breast cancer patients according to real-world data from a large Swedish population-based registry.." Breast cancer research : BCR, vol. 28, no. 1, 2026.
PMID
41918024
Abstract
[BACKGROUND] PREDICT is a widely used prognostic tool supporting treatment decisions in breast cancer care. As v3.0 was recently released, we performed an external validation of PREDICT v2.2 and v3.0 in young (≤ 40 years) breast cancer patients.
[METHODS] We included Swedish non-metastatic breast cancer patients aged ≤ 40 years, diagnosed between 2008–2019, from a registry-based research database. Outcomes were all-cause and breast cancer-specific mortality (BCSM) at 5- and 10-years, in all and in prespecified patient subgroups (by molecular subtype and nodal status). Model calibration and discrimination were evaluated by the integrated calibration index (ICI) and time dependant area under the receiver operator curve (tdAUC), respectively.
[RESULTS] In total, 3015 patients were included. PREDICT v2.2 consistently overestimated both all-cause mortality and BCSM at 5- (ICI = 5.10%, 95% confidence interval (CI) 4.93–5.27; ICI = 4.91%, 95% CI 4.71–5.13) and 10- years (ICI = 9.75%, 95% CI 9.02%–10.5, ICI = 9.71%, 95% CI 8.88–10.4). In contrast, PREDICT v3.0 showed much better calibration (5 years; ICI = 0.69%, 95% CI 0.60–0.78; ICI = 0.65%, 95% CI 0.57– 0.73; 10 years; ICI = 5.10%, 95% CI 4.65–5.5%; ICI = 4.76%, 95% CI 4.31–5.19), although miscalibration remained in high-risk groups. Discrimination was excellent for predicting 5-year outcomes in both models but declined for 10-year predictions.
[CONCLUSIONS] PREDICT showed good discrimination in young patients. Although version 3.0 showed better calibration than v2.2, risk overestimation in high-risk patients may affect treatment decision-making and warrants cautious interpretation.
[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1186/s13058-026-02271-2.
[METHODS] We included Swedish non-metastatic breast cancer patients aged ≤ 40 years, diagnosed between 2008–2019, from a registry-based research database. Outcomes were all-cause and breast cancer-specific mortality (BCSM) at 5- and 10-years, in all and in prespecified patient subgroups (by molecular subtype and nodal status). Model calibration and discrimination were evaluated by the integrated calibration index (ICI) and time dependant area under the receiver operator curve (tdAUC), respectively.
[RESULTS] In total, 3015 patients were included. PREDICT v2.2 consistently overestimated both all-cause mortality and BCSM at 5- (ICI = 5.10%, 95% confidence interval (CI) 4.93–5.27; ICI = 4.91%, 95% CI 4.71–5.13) and 10- years (ICI = 9.75%, 95% CI 9.02%–10.5, ICI = 9.71%, 95% CI 8.88–10.4). In contrast, PREDICT v3.0 showed much better calibration (5 years; ICI = 0.69%, 95% CI 0.60–0.78; ICI = 0.65%, 95% CI 0.57– 0.73; 10 years; ICI = 5.10%, 95% CI 4.65–5.5%; ICI = 4.76%, 95% CI 4.31–5.19), although miscalibration remained in high-risk groups. Discrimination was excellent for predicting 5-year outcomes in both models but declined for 10-year predictions.
[CONCLUSIONS] PREDICT showed good discrimination in young patients. Although version 3.0 showed better calibration than v2.2, risk overestimation in high-risk patients may affect treatment decision-making and warrants cautious interpretation.
[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1186/s13058-026-02271-2.